Giant pleural mesothelioma associated with hypoglycemia and hyperthyroidism

Our plain-English summary of Giant pleural mesothelioma associated with hypoglycemia and hyperthyroidism, by G.J. Devroede, A.F. Tirol (American Journal of Surgery, 1968).

The study

• Authors: G.J. Devroede, A.F. Tirol
• Journal: American Journal of Surgery
• Published: 1968;116(1):130-4
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of pleural mesothelioma associated with the unique combination of hypoglycemia and hyperthyroidism in a fifty-six year old woman is presented. Irradiation of the tumor resulted in temporary suppression of hypoglycemia. The neoplasm was excised two years after it was discovered and, thus far, eighteen months postoperatively, there has been no recurrence of the tumor, hypoglycemia, or hyperthyroidism.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This article is a case report of one patient, a 56-year-old woman at St. Vincent Hospital in Erie, Pennsylvania. She had a very large tumor of the pleura (the chest lining), together with low blood sugar (hypoglycemia) and an overactive thyroid (hyperthyroidism). The article does not mention asbestos or give any occupational or environmental exposure history. When she was admitted in August 1963 with episodes of incoherence, a mass filled almost the entire right side of her chest. It was too extensive for surgery, so it was treated with radiation. Her symptoms gradually disappeared, although the tumor did not shrink on X-ray. In June 1965 she returned semicomatose. She went into hypoglycemic shock with a blood sugar of 28 mg. per cent, and she had an enlarged thyroid with laboratory signs of hyperthyroidism. The tumor was then removed whole. It measured 23 by 18 by 11 cm and was diagnosed as fibrous mesothelioma. Afterward the hypoglycemia stopped and the hyperthyroidism did not return. Eighteen months after surgery there had been no recurrence. The authors noted that they did not measure thyroid-stimulating hormone, so they could not prove that the operation was the only factor affecting the hyperthyroidism.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 56-year-old white married woman, first admitted August 17, 1963, at St. Vincent Hospital, Erie, Pennsylvania, and followed until 18 months after surgery in 1965
• Exposure: Not reported; the article does not mention asbestos or give any occupational or environmental exposure history
• Main results:
  • At first admission, a chest X-ray showed a large mass occupying almost the entire right side of the chest
  • After palliative irradiation, the tumor did not shrink on X-ray but her symptoms gradually disappeared
  • At readmission in 1965, when intravenous glucose was stopped, the patient went into hypoglycemic shock with a blood sugar of 28 mg. per cent
  • Laboratory evidence of hyperthyroidism in this patient: protein-bound iodine 16.5 (normal 4 to 8) and thyroxine-binding index 0.70 (normal 0.86 to 1.20)
  • The excised tumor measured 23 by 18 by 11 cm and was diagnosed as fibrous mesothelioma
  • After the tumor was removed, the episodes of hypoglycemia stopped and the glucose tolerance curve became normal
  • Thyroid medication was stopped without return of hyperthyroidism, and 18 months after surgery there was no recurrence of the tumor, hypoglycemia, or hyperthyroidism
• The authors' conclusion: The authors considered the unique feature of the case to be that the tumor caused hypoglycemia and hyperthyroidism at the same time. They stressed that surgical removal of such tumors can produce remissions or cures in the fibrous tumor group.
• Limitations the authors state:
  • Thyroid-stimulating hormone (TSH) was not measured, so the authors could not prove that the operation was the only factor affecting the hyperthyroidism

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Neoplasm.

Related studies

• Solitary fibrous tumor of the pleura. An immunohistochemical, electron microscopic and tissue culture study of a tumor producing insulin-like growth factor I in a patient with hypoglycemia — E.H. Strøm, F. Skjørten, et al. (1991)
• Malignant mesothelioma associated with hypoglycemia; report of a case — K.A. Nesbitt, J.T. Boswell, et al. (1958)
• Causes and evaluation of tumor-induced hypoglycemia — S.C. Immerman, S.F. Sener, et al. (1982)
• Giant fibrous pleural mesothelioma associated with myocardial restriction and hypoglycemia — D.O. Kniznik, A.J. Roncoroni, et al. (1979)
• Benign pleural mesothelioma with tumour-induced hypoglycaemia — K.R. Burgess, J. Rutland, et al. (1982)
• Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy — S. Yilmaz, V. Kirimlioglu, et al. (2000)

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